PMCT of Gunshot Wounds

PMCT of Gunshot Wounds

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This webinar originally occurred on April 27th, 2021
Duration: 1 hour

In the third webinar, participants were introduced to the use of PMCT for examining decedents with gunshot wounds, both homicidal and self-inflicted.  At the New Mexico OMI, a PMCT scan is performed in virtually all gunshot wound (GSW) related deaths.  In cases of suspected homicide or suspicious suicides, autopsy is also performed.  However, in non-suspicious cases involving self-inflicted GSW, PMCT is combined with an external examination, and sometimes a partial autopsy to retrieve a retained projectile, replacing the full autopsy.

Participants were introduced to how PMCT is used to determine the number and location of retained projectiles of various types, projectile fragments, and related debris.  The CT appearance of entrance and exit wounds of the skull, and associated fractures, will be illustrated and discussed.  The webinar discussed the appearance of wound tracks in other anatomic locations, including injuries to skin, soft tissue, organs, and bony tissue, and how the identification of these injuries by PMCT can be helpful in delineating trajectory.  Factors that may complicate the determination of trajectory, such as ricochet and exit/re-entry, will also be discussed.

Finally, potential pitfalls and limitations of the use of PMCT were described.  These include range of fire determination, retained projectiles from past GSWs, and foreign bodies that mimic the appearance of projectiles.

Detailed Learning Objectives:
1.) Participants will have a basic understanding of how PMCT can be utilized in triaging firearm deaths.
2.) Participants will be familiar with the PMCT appearance of projectiles and fragments, entrance and exit wounds, and characteristic injuries to hard and soft tissues along a wound track.
3.) Participants will be aware of the benefits and limitations to the use of PMCT in the investigation of firearm deaths.

Presenter: Lauren Decker, MD | Medical Examiner at the New Mexico Office of the Medical Investigator and Director of the Forensic Pathology Fellowship Training Program

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Funding for this Forensic Technology Center of Excellence event has been provided by the National Institute of Justice.

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